7 . Colonoscopy and severe hematochezia

نویسنده

  • Gustavo A. Machicado
چکیده

Hematochezia is the passage of bright red blood or maroon colored blood, with or without clots, per rectum. Most often hematochezia is low grade and self limited and does not require hospitalization or urgent intervention. Such patients can be managed in an outpatient setting. A smaller group of patients experience severe hematochezia and require hospitalization because of the volume of blood loss or symptoms due to severe anaemia or comorbidity[1,2]. In addition, another group of severely ill patients will develop severe hematochezia while in the hospital for other medical or surgical conditions. These latter two groups require a systematic and expeditious approach to their resuscitation, preparation, diagnosis, and treatment. For more than a decade, our CURE-UCLA Hemostasis Group has recommended an aggressive diagnostic approach with preparation of the patient with oral purge followed by urgent colonoscopy for diagnosis and treatment. This approach is similar to that used for patients with severe UGI hemorrhage. This approach changes outcomes of patients, particularly for those with severe or persistent hematochezia[1,2]. This paper reviews:

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Infertility associated with hematochezia: A complication of perforated appendicitis

Introduction: Infection and inflammation of organs adjacent to gastrointestinal tract may cause a pathological connection. Patient: In this report, complicated appendicitis caused protrusion of right ovary and tube into the sigmoid colon of a 40-year-old infertile woman. The mass appearing as a polypoid lesion during colonoscopy caused abdominal pain and bleeding and proved to be right adnexa p...

متن کامل

Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage.

BACKGROUND Although endoscopy is often used to diagnose and treat acute upper gastrointestinal bleeding, its role in the management of diverticulosis and lower gastrointestinal bleeding is uncertain. METHODS We studied the role of urgent colonoscopy in the diagnosis and treatment of 121 patients with severe hematochezia and diverticulosis. All patients were hospitalized, received blood transf...

متن کامل

Short Term Outcome of Patients with Hematochezia and Normal Initial Colonoscopic Findings: Do They Really Need Further Screening?

BACKGROUND In a significant number of the patients with hematochezia, colonoscopy turns out to be normal and therefore is unable to determine the cause of bleeding. This study investigates outcomes and possible necessity for further work up in cases of hematochezia with normal colonoscopy. METHODS Ninety-seven patients with normal colonoscopy were followed for at least one year from the time ...

متن کامل

Lower Gastrointestinal Bleeding: Is Urgent Colonoscopy Necessary for All Hematochezia?

Lower gastrointestinal bleeding (LGIB) is defined as acute or chronic abnormal blood loss distal to the ligament of Treitz. The incidence of LGIB is only one fifth of that of the upper gastrointestinal tract and is estimated to be 21 to 27 cases per 100,000 adults per year. Acute bleeding is arbitrarily defined as bleeding of <3 days' duration resulting in instability of vital signs, anemia, an...

متن کامل

Appropriateness of colonoscopy indication for colorectal neoplasm detection in patients under 50 years old with hematochezia

Objective: Evaluate the appropriateness of colonoscopy indication for neoplastic lesion detection in patients under age 50 with hematochezia. Methods: Retrospective and cross-sectional study in patients who underwent colonoscopy, from 2002 to 2009. Inclusion criteria included patients with hematochezia over 20 years old. Exclusion criteria were: history of inflammatory bowel disease (IBD), poly...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2005